Thursday, December 31, 2009

Bertalan Mesko, MD (pictured) has created a nice collection of pathology web resources called PeRSSonalized Pathology, which features the best medical journals, news sites, blogs and tweeters dedicated to pathology. Needless to say, Neuropathology Blog is included! "If you have any suggestions," says Dr. Mesko, "feel free to send those to me so I can improve the resource." Dr. Mesko can be emailed at info@webcina.com.

Monday, December 28, 2009

The next in our series of "Best Posts of the Month" is from August 2, 2009:

A new edition of the canonical Robbins and Cotran Pathologic Basis of Disease appeared recently and is no doubt being widely purchased by second-year medical students throughout the country as they begin the academic year later this month. I emailed the authors of the neuropathology-related chapters and asked them what was new and improved about the 8th edition. First, Douglas C. Anthony, MD, PhD of the University of Missouri Pathology Department(pictured below), who co-authored the chapters on the peripheral and central nervous systems with Drs. Matthew Frosch and Umberto DiGirolomi, had the following to say about the the new edition:

"The neuro chapters were quite an undertaking, trying to incorporate all the progress in neurosciences without making the new edition so big that it's unattractive to medical students. We tried very hard to keep it near the same size, and use more illustrations to keep it concise. One thing that we did throughout the 8th edition is to reduce the discussions of normal histology (only placing some of it where it's necessary to understand the pathology). So normal nerve, muscle, and brain are all removed. That allowed us to introduce more on advances in molecular understanding of all the pathologic processes. We have done that throughout, but in some places removed the text to create [tables] or figures. For example, hereditary sensory and autonomic neuropathies are expanded as a table, and the hereditary motor and sensory neuropathies as a figure with the myelin layers. For the limb-girdle muscular dystrophies, we listed all that were known at the time of press, and included others as separate hereditary myopathies. We included congophilic angiopathy with hemorrhages, and included a CADASIL figure, and expanded molecular classifications where they are pertinent to management, such as MGMT in glioblastomas and chromosome 1/19 in oligos. Where there was just too much to include in an introductory pathology text, we referenced more detailed papers or major texts, to send the interested student to those."

Next, I contactedRobert Folberg, MD(pictured below), ophthalmic pathologist and dean of the Oakland University William Beaumont School of Medicine in Michigan, for his take on the chapter he authored on the eye. His statement follows:"The major revision [in the eye chapter] was the jump between the 6th and 7th edition. The chapter was revised completely during the 6-7 edition transition. The current chapter is a bit shorter - as are most chapters in the book - and the references and some concepts have been updated. There are no 'earth-shattering' changes between [the 7th and 8th editions]."

There you have it. I am sure I can speak for all of the readers of this new edition, both students and faculty alike, in expressing my appreciation for the countless hours of work that went into creating this text. I look forward to diving into it as the new academic year begins!

Thursday, December 17, 2009

Modern Surgical Neuropathology by Dr. Doug Miller (pictured) was reviewed by Dr. Leroy Sharer in last month's Journal of Neuropathology and Experimental Neurology. (I published a post on this book in June of this year.) Dr. Sharer points out that Dr. Miller's book is extraordinary in that it is penned by a single author -- "a rarity in medical publishing in the 21st century", writes Sharer. Some may take issue with Dr. Miller's fiercely independent perspective on surgical neuropathology, but one must respect his courage to say what he thinks. He is not afraid to challenge mainstream concepts. For instance, in his review, Dr. Sharer notes that Dr. Miller "devised his own tumor grading and classification schema, which he relates to others in use, particularly the World Health Organization system from 2007". If more neuropathologists had the chutzpah to put their perspectives out in the public arena for debate, it would undoubtedly invigorate the field!

Sunday, December 13, 2009

It is not often that we neuropathologists find ourselves the subject of public admiration. We are, after all, an obscure lot. But Dr. Cecilia Rohdin (pictured), a Swedish veterinary neurologist, is a true fan. She writes:"I work at the University Animal Hospital in Uppsala, the only teaching hospital in Sweden for veterinary studies. I love animals and neurology and I would like to learn more neuropathology. Unfortunately veterinary neuropathology is not an area of great interest and excellence in Sweden. I would love the opportunity to be able to discuss unsolved mysteries and to learn more about the challenging but ever so fascinating world of neuropathology."
And now, a few questions for our featured fan:

Why are you interested in the neurology of cats and dogs?"My interest in neurology started when I realized what a neglected field neurology was in veterinary medicine. I do believe that these patients deserve a diagnosis... Besides, neurology is extremely fascinating and it involves both medicine and surgery (at least in veterinary medicine where I am able to do both)."

What role can human neuropathologists play in the work that you do?"A neuropathologist would be a dream come true for me!! I stuggle to find someone interested to make an effort to examine these patients properly and with enthusiasm. I know it is difficult for a general pathologist to interpret changes in the nervous system and I sometimes get very obscure and not always accurate pathology reports. I also want to be able to do reasearch and it is difficult to find someone (also abroad) to have the time and interest. I would like to know enough to not be so dependent on pathologists who are not really neuropathologists. I also want to learn to get a better general picture of my cases."

I see from your curriculum vitae that you are particularly interested in canine and feline motor neuron diseases. Do you want to hear from neuropathologists who share your research interests? If so, how should they contact you?
Yes! I can be reached via email at: cecilia.rohdin@live.se

Thanks for reading Neuropathology Blog, Dr. Rohdin. And thanks for the work you do in helping to relieve the suffering of our fellow mammals!

Thursday, December 3, 2009

The recent hullaballoo, which included my own blog post on the subject, regarding the long-term consequences of football-related traumatic brain injury has moved the National Football League to take measures to more aggressively manage players who suffer concussions. The New York Times reported yesterday that players who exhibit any significant sign of concussion will be removed from a game or practice and be barred from returning the same day. The new rules will take effect in this week's games. I salute the forthright manner in which the NFL is dealing with new concerns regarding the brain injuries that are intrinsic to the game. I would advocate more dramatic rules changes, such as requiring that linemen start each play in an upright position rather than in the traditional three point stance exemplified in the now-defunct New England Patriots logo pictured. Regardless of what changes are made at the professional or school-boy level, I still intend to prohibit my own son from ever playing the sport of football. As Dr. Joseph Maroon, the team neurosurgeon for the Steelers and a member of the N.F.L.’s committee on concussions said: "On every play there are traumatic experiences to the head." The football season is short, and life is long. Thanks to Drs. Doug Shevlin and Mike Beckmann for making me aware of these emerging developments.

Wednesday, December 2, 2009

The Brain Observatory at the University of California San Diego is today beginning a 30-hour brain cutting session with a live online stream of the procedure wherein the brain of H.M., an amnestic patient, is being thinly sliced from front to back into whole-mount frozen histologic sections. Each brain slice will be approximately 70 microns thick, about the thickness of a human hair. An average-sized brain produces 2,600 to 3,000 such slices. The UCSD Brain Observatory, headed by Dr. Jacopo Annese, is dedicated to the study of the architecture of the human brain using multiple complementary imaging modalities, including autopsy. Thanks to Thomasina Bailey for alerting me to this extraordinary brain cutting event!